单纯椎板切除后发生椎间盘突出的危险因素分析

Analysis on risk factor for lumbar disc herniation after decompression

目的分析椎管狭窄减压术后患者发生腰椎椎间盘突出的危险因素,为患者术后康复提供参考。方法选择因椎管狭窄行部分椎板双侧切除术的患者169例,将发生椎间盘突出的患者24例作为椎突组,未发生椎间盘突出的患者145例作为对照组。分析2组研究对象各种影像学检查数据。利用多元logistics回归分析和ROC曲线分析危险因素。结果脊柱伸展后滑脱是椎间盘突出的独立危险因素(1.24,95%CI[1.07~1.43];P<0.01);曲线下面积(AUC)为0.801,截断值为6.89%。结论术前椎体后滑脱可能是椎间盘突出的独立危险因素。

Objective The study aimed to identify risk factors of lumbar disc herniation in patients after decompression, and provide theoretical basis for postoperaive rehabilitation. Methods A told of 169 patients with lumbar spinal stenosis underwent bilateral partial laminectomy were included in the study,24 patients in herniation group,and 145 patients without develop postoperative acute sciatica as a control group. The radiographic variables were measured. The threshold of risk factors was evaluated by multiple logistics analysis and receiver operating characteristic curve（ROC） analysis. Results The results revealed that preoperative retrolisthesis during extension was the independent risk factor for lumbar disc herniation （ 1.24,95 % CI[ 1.07 - 1.43 ] ; P 〈 0.01 ）. The area under the curve （ AUC ） was 0.801, and the cutoff value was 6.89%. Conclusion The preoperative retrolisthesis was the risk factor of lumbar disc herniation.